Politics

Wheels said:

Bad things happen when you don't pay your child support.

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Rob404 said:

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Wheels said:

Many years in jail.

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sgt_zim said:

There is the seen, and the unseen.

What you are not seeing is the cost transfer onto the backs of the very people you propose to help. Every government program bears a cost, and the cost of those programs is always transferred to the final consumer, either via higher prices, or absence of employment opportunities. High income earners, like many of us here, find this a nuisance. Those at median income levels find their lives quite affected. Those well below median income find life impossible.

If a tax or regulation increases production costs, the business owners don't ordinarily pay those costs, they just raise their prices to recover those costs, to the point they can no longer be competitive with international providers of those products. Those domestic entities either close up shop, or they move production overseas. So...prices go up, and opportunities for gainful employment go down.

I *strongly* encourage you to read Friedman, Hazlitt, von Mises, Hayek, Bastiat, and a host of others. Much of that reading is available for FREE at https://fee.org/. Start with Henry Hazlitt's "Economics in One Lesson." It's short, maybe 100 total pages, and written in plain English, unlike the Keynesian/Marxist gibberish designed to confuse, and only amounts to so much navel-gazing. Reading very much of any of those guys will lead you to discover the futility of those things for which you are currently an advocate.

If you want to understand why that social safety net not only doesn't work, but (more importantly) is utterly immoral, then read Ayn Rand for good measure.

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sgt_zim said:

From https://fee.org/articles/the-chart-that-could-undo-the-us-healthcare-system/

There is only 1 reason for the explosion in hospital administrative jobs, and thus the massive increase in health care delivery costs - government regulation, driven almost exclusively by Medicare/Medicaid. The best social safety net ever yet discovered is liberty.

Health care delivery is light years more efficient today than it was when I was a kid, driven largely by advances in diagnostics, which were themselves driven by advances in math, physics, and engineering. Prior to computerized tomography (CT scan) and MRI (magnetic resonance imaging) in the 70s and 80s, if a doctor couldn't discover the issue with x-rays and lab tests (which themselves have advanced greatly in that time), they would do exploratory surgery. If you think a few thousand USD for a CT or MRI is expensive, try renting a surgical suite for a few hours for the surgeon to try and dig around to find something. And then there's the recuperation period from that surgery. And the anesthesiologist, and the nurses, and post-op care within the hospital for several days.

And yet with all those efficiency gains, costs spiral out of control. Again, I will refer you to the chart above as a refresher as to why.

We both want the same thing. But government-sponsored "safety nets" of any sort, for any thing, always increase the cost to the final consumer. And the folks who can least afford those cost increases are the folks you're trying to help.

I'm not trying to be snarky, but the pernicious myth that governments can "help" people must be buried, and the earth above the casket needs to be salted.

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Rob404 said:

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Ray B said:

Sgt Zim,

One of the changes that your graph doesn't show is the distribution of time by the physicians. While the number of administrators have skyrocketed and the number of physicians has only increased by a percentage . . . .

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tigris115 said:

This may not be 100% true but I also think that being a doctor is seen as one of those jobs that you do for the money. Thus, new medical professionals are very money motivated. Medicine needs to be a more philanthropic profession.

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Ayn Rand said:

I quit when medicine was placed under State control some years ago. Do you know what it takes to perform a brain operation? Do you know the kind of skill it demands, and the years of passionate, merciless, excruciating devotion that go to acquire that skill? That was what I would not place at the disposal of men whose sole qualification to rule me was their capacity to spout the fraudulent generalities that got them elected to the privilege of enforcing their wishes at the point of a gun.

I would not let them dictate the purpose for which my years of study had been spent, or the conditions of my work, or my choice of patients, or the amount of my reward. I observed that in all the discussions that preceded the enslavement of medicine, men discussed everything except the desires of the doctors.

Men only considered the “welfare” of the patients with no thought for those who were to provide it. That a doctor should have any right, desire or choice in the matter was regarded as irrelevant selfishness, his is not to choose, they said, only “to serve.”

That a man who’s willing to work under compulsion is too dangerous a brute to entrust with a job in the stockyards — never occurred to those who proposed to help the sick by making life impossible for the healthy. I have often wondered at the smugness with which people assert their right to enslave me, to control my work, to force my will, to violate my conscience, to stifle my mind — yet what is it they expect to depend on, when they lie on an operating table under my hands? Their moral code has taught them to believe that it is safe to rely on the virtue of their victims. Well that is the virtue I have withdrawn. Let them discover the kind of doctors that their system will now produce. Let them discover in their operating rooms and hospital wards that is it not safe to place their lives in the hands of a man whose life they have throttled. It is not safe, if he is the sort of man who resents it — and still less safe if he is the sort who doesn’t.

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sgt_zim said:

Hmmm...why shouldn't they be able to make a lot of money?

Do you know what it takes to be a doctor? First, if you don't graduate college magna cum laude or summa cum laude, your odds of getting into medical school are slim. That's 4 years of hard work as an undergrad, which all by itself ain't cheap. Even for English majors, prerequisites for med school are the same: 8 hrs of freshman chemistry and lab, another 8 hrs of organic chemistry and lab, 6 or 8 hours of physics (which requires proficiency in college level algebra as well as the calculus), and a lot of biology/microbiology. And then do well on MCAT. Then study your guts out for 4 years of med school. Then there's residency, a minimum of another 3 years of even more studying than they did in med school. Some residencies are 5 years (orthopedics, for one, is 5 years). And some docs who finish residency go on to do fellowships (another 2 years) in specialties like cardiology, pulmonology, infectious diseases, endocrinology, nephrology, and quite a number more.

And you actually expect that, with an extra 10-15 years of very intensive post-secondary study, they shouldn't be interested in making a lot of money when they're finally allowed to practice medicine unsupervised???

Tell ya what. Become a doctor and do your own philanthropic work. It is the height of hubris to suggest other people ought to follow your model.

My brother-in-law is a pulmonologist. He works about 80-90 hrs a week. He only collects about half of what he bills. My sister is a pediatrician. Because of state medicaid requirements, their practice actually loses money on medicaid patients. But they cannot turn them away. So they had to hire a nurse practitioner to take care of the medicaid patients. At the NP's salary, she's a break-even, instead of a loss to the practice.

I used to be a nurse. Most doctors I know want to quit, in spite of the good money. They're tired of the bullshit. My sister has been ready to quit her medical practice since the early 2000s.

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